Childhood trauma, depression, and the risk of incident prediabetes in young adults: findings from the Lifelines Cohort Study

Abstract Background Childhood trauma and depression have been shown to increase the risk of type 2 diabetes. However, many studies have focused on middle-age and older adults, with less known on the role of these variables in early glucose dysregulation. The goal of the study was to examine childhood trauma, depression, and their interactions, as risk factors for the onset of prediabetes in young adults. Methods Data were from the Dutch Lifelines Cohort Study. N = 8,650 adults (61% female) between 18-35 years without prediabetes/diabetes at baseline (2007-2014) were included. Childhood trauma was assessed using the Childhood Trauma Questionnaire. Depression was assessed using the Mini International Neuropsychiatric Interview. Prediabetes at follow-up (2014-2017) was considered by haemoglobin A1c levels between 5.7%-6.4%. Logistic regressions examined associations between depression and childhood trauma with the risk of incident prediabetes. Odds ratios (OR) and 95% confidence intervals (CI) for unadjusted analyses and analyses adjusted for age, sex, education, ethnicity, body mass index, smoking, and alcohol use (reduced adjusted sample size; n = 7,186) are presented. Results 244 participants (2.8%) developed prediabetes. In univariate analyses, childhood trauma (OR = 1.02, CI = 1.01-1.03, p=.006) and depression (OR = 2.08, CI = 1.01-4.29, p=.048) predicted incident prediabetes. When childhood trauma subscales were examined, only sexual abuse significantly predicted incident prediabetes. In adjusted analyses, only childhood trauma, specifically sexual abuse, significantly predicted incident prediabetes (OR = 1.06, CI = 1.01-1.12, p=.021). No multiplicative interaction between depression and childhood trauma was found. Conclusions Young adults who have experienced childhood trauma, particularly sexual abuse, may be at risk of glucose dysregulation in early adulthood. Early targeted preventive care may help attenuate or halt glucose dysregulation and the development of type 2 diabetes.


Background:
Research shows that anxiety is connected to a variety of mental health outcomes, and that it is widespread among the population. In the light of the great personal and societal costs of obesity and eating disorders, we want to understand the connection between anxiety and different dimensions of eating behaviors that have a strong empirical link with negative eating-related health outcomes.

Methods:
We used data from the population-based LIFE-Adult-Study (n = 5019) to analyze the connection between anxiety (GAD-7) and the three dimensions of eating behaviors: Cognitive Restraint, Disinhibition, and Hunger (FEV, German version of the Three-Factor-Eating-Questionnaire). We controlled for sociodemographic variables, smoking, physical activity, personality, and social support.

Conclusions:
There is an empirical connection between anxiety and two factors of eating behavior, i.e., Disinhibition and Hunger. If future research strengthens the assumption of a causal direction from anxiety to those factors, interventions that help individuals to better regulate and cope with anxiety, could be one potential pathway to reducing eating disorders and obesity in the population.

Key messages:
There is a significant connection between anxiety and eating behavior.
Interventions that address anxiety could reduce problematic eating-related health outcomes like eating disorders and obesity.
11.D. Workshop: Depression comorbidity in prediabetes and diabetes: evaluating risk factors and outcomes Abstract citation ID: ckac129.699 Organised by: Tuebingen University (Germany) Chair persons: Norbert Schmitz (Germany) Contact: norbert.schmitz@med.uni-tuebingen.de Depression is a common comorbidity in prediabetes and diabetes. Evidence for the interaction of depression and behavioural and biological risk factors for (pre-) diabetes and diabetes-related outcomes will be presented and discussed using longitudinal data from the Lifelines Cohort, the Canadian Longitudinal Study on Aging, and the Cartagene study. In addition, digital phenotyping will be discussed as an alternative approach for the assessment of mobility and behaviour in people with diabetes. Key messages: Behavioural, psychosocial and biological risk factors might increase the risk of poor diabetes outcomes in a synergistic way. Prevention program for diabetes and diabetes realted outcomes should focus on behavioural, psychosocial and biological risk factors simultaneously.

Background:
Childhood trauma and depression have been shown to increase the risk of type 2 diabetes. However, many studies have focused on middle-age and older adults, with less known on the role of these variables in early glucose dysregulation. The goal of the study was to examine childhood trauma, depression, and their interactions, as risk factors for the onset of prediabetes in young adults.

Background:
Depression is a common co-morbidity in diabetes. The mechanisms underlying the association between depression and diabetes are poorly understood. Although risk factors, such as poor lifestyle behaviours, obesity, and stress have been identified, emerging evidence suggests that systemic inflammation may play an important role in the pathogenesis and recurrence of depression in people with diabetes. The aim of the present study was to evaluate if the inflammatory marker C-reactive protein (CRP) is associated with an increased risk of major depression episodes in people with type 2 diabetes.

Methods:
A prospective, community-based study was conducted in Quebec, Canada. Individuals were recruited from the CARTaGENE (CaG) cohort, a population-based survey of Quebec residents aged 40 to 69 years. Our sample included 719 individuals with type 2 diabetes and 1423 individuals without diabetes. Individuals were assessed at baseline and 5 years after baseline. Major depression disorders were assessed using a clinical interview (CIDI). Inflammatory markers were assessed from blood samples. Elevated CRP levels were defined as 3 mg/L.

Results:
Participants with both diabetes and elevated CRP levels had the highest risk of major depressive episodes (adjusted OR = 1.90, 95% CI 1.45, 2.50), compared to those without diabetes and without elevated CRP levels. The risk of major depressive episodes in individuals with diabetes without elevated CRP episodes was lower (adjusted OR = 1.21, 95% CI 0.85, 1.73) and similar to the risk of those without diabetes and elevated CRP levels (adjusted OR = 1.15, 95% CI 0.94, 1.39).

Discussion:
The study highlights the interaction between diabetes, inflammatory makers, and depression in a community sample. Early identification, monitoring, and management of elevated inflammation levels might be an important depression prevention strategy in people with type 2 diabetes.

Background:
Individuals who ultimately receive a diagnosis of dementia typically have an observable accelerated cognitive decline (ACD) many years prior to diagnosis. Depression in combination with diabetes is an emerging risk factor that is associated with cognitive problems. Using data from the Canadian Longitudinal Study on Aging, the objective of the present study was to investigate the longitudinal association between depression, diabetes, and cognitive decline in an elderly cohort.

Methods:
Baseline and follow-up data from a population-based study in Canada were used. The sample consisted of 18161 adults between 45 and 85 years of age without diabetes. Cognitive functioning was assessed at baseline and after 4 years using six measures: the Rey Auditory Verbal Learning Test (RAVLT), the Mental Alternation Test (MAT), the Animal Fluency Test (AF), the Controlled Oral Word Association Test (COWAT), the Stroop Test, and the Prospective Memory Test. Depression was assessed using the CES-D10. Regression analysis was conducted to evaluate interactions between depression, diabetes and cognitive decline.

Results:
The mean age of participants was 61 years. Participants with a comorbidity of depression and diabetes had an accelerated cognitive decline (g-factor) compared to those with depression without diabetes and those with diabetes without depression (regression coefficients ß = -0.145 (0.036), ß = -0.076 (0.011), and ß = -0.053 (0.021), respectively).

Conclusions:
This study suggests that depression and diabetes might increase the risk of cognitive decline in a synergistic way.

Introduction:
Societal restrictions due to COVID-19 have had a profound effect on our ability to connect with one another and limited our personal mobility. There is evidence that loneliness, social isolation, and psychological distress increased during restrictions for people with diabetes. Fluctuating restrictions provide a unique opportunity to utilise continuous GPS data from personal smartphones (digital phenotypes) to explore the relationship between time-at-home and psychosocial health for people with diabetes. This study aims to (1) describe the digital phenotypes of time-at-home during varying societal COVID-19 restrictions for people with and without type 2 diabetes and